淋巴增强因子1在慢性粒细胞白血病中的表达及其临床意义

目的 探讨慢性粒细胞白血病慢性期(CML-CP)患者骨髓单个核细胞中淋巴增强因子1(LEF-1)mRNA表达水平并分析其临床意义.方法 应用实时荧光定量聚合酶链反应测定38例CML-CP患者初诊和伊马替尼治疗后及20名正常对照骨髓单个核细胞的LEF-1 mRNA表达水平,分析其与伊马替尼治疗获得主要分子学反应(MMR)的关系.结果38例CML-CP初诊患者LEF-1 mRNA中位相对表达水平为0.00214(0.00020~0.02120),高于20名正常对照者[0.00101(0.00009~0.00233)](U=163.0,P<0.01);38例患者经伊马替尼治疗后,25例获得MMR者LEF-1 mRNA中位相对表达水平为0.00107(0.00010~0.00519),低于13例未获得MMR者[0.01015(0.00091~0.03615)](U=25.0,P<0.01),获得MMR组LEF-1 mRNA表达水平与正常对照组差异无统计学意义(U=201.0,P>0.05),未获得MMR组LEF-1 mRNA表达水平高于正常对照组(U=14.0,P<0.01).口服伊马替尼治疗18个月时,初诊时LEF-1 mRNA高表达组MMR率为84.2%(16/19),高于LEF-1 mRNA低表达组的47.4%(9/19)(χ2=4.209,P<0.05).25例获得MMR的患者中,初诊时LEF-1 mRNA高表达组达到MMR平均时间为(10.0±4.5)个月,短于LEF-1 mRNA低表达组的(14.6±3.8)个月(t=2.705,P<0.05).结论 LEF-1可能参与CML的发生、发展,可反映肿瘤负荷,可能是预测伊马替尼疗效的指标之一.

Expression of lymphoid enhance factor 1 in chronic myeloid leukemia and its clinical significance

Objective To analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1), and to investigate its clinical significance in bone marrow mononuclear cells of patients with chronic myeloid leukemia chronic-phase (CML-CP) after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction was used to measure the expression level of LEF-1 gene in 38 CML-CP patients after initial diagnosis and chemotherapy and 20 persons without blood system diseases and neoplastic diseases as normal control. The difference of LEF-1 expression level between the patients and healthy control was compared, and the effect of imatinib on the main molecular response (MMR) was analyzed. Results The expression of LEF-1 mRNA in 38 newly diagnosed patients [0.00214 (0.00020 - 0.02120)] was significantly higher than that in normal controls [0.00101 (0.00009 - 0.00233)] (U= 163.0, P< 0.01). The expression of LEF-1 mRNA in MMR group [0.00107 (0.00010 - 0.00519)] was significantly lower than that in non-MMR group [0.01015 (0.00091 -0.03615)] (U= 25.0, P< 0.01). There was no significant difference in LEF-1 mRNA expression between the normal control group and the MMR group after imatinib treatment (U= 201.0, P> 0.05). The level of LEF-1 mRNA expression of non-MMR group was also higher than that of the normal control group (U= 14.0, P<0.01). The rate of acquiring MMR was significantly higher in high LEF-1 mRNA expression group [84.2 %(16/19)] than that in low expression group [47.4%(9/19)] (χ2=4.209, P<0.01). The time of acquiring MMR was significantly shorter in the high LEF-1 mRNA expression group [(10.0 ± 4.5) months] than that in the low expression group [(14.6 ± 3.8) months] (t= 2.705, P< 0.01). Conclusions LEF-1 may be involved in the occurrence and development of CML, and reflects the tumor burden. It may be one of the indicators to predict the efficacy of imatinib.